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HomeMy WebLinkAboutDRAKE BLK 1 LT 3A[)rake Block 1 Lot 3A #017-461-22 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAM �© PHONE ! ❑UPGRADE MAI LING A�R �SA LEG%� DESCRrIPTION /� t.� e it -SQ LOCATION NO. OF &TOOMS V DISTANCE TO:®Q Well Absorptirry Dwel ' g pj PER NQ_ _Y I­ Z W H� Manufacturer Mater' No. of comp ments y Liq. cZtb gal Ions IF HOMEMADE: Inside length Width Liquid dept 6Y j0 DISTANCE TO: Well Dwelling PERMIT NO. SF Manufacturer Material Liquid capacity in gallons 0 = w DISTANCE TO: Well�` Found�tio ' / Nearest o line PER b J u Z Z w No. of lines / Length e�Gli�ine (� Total th .lines Trench id h inches Distance tyetw n lines �f ° F. p Top of tile to finish grade Material beneath tile ! inches Total effective absorption area w Length Width Depth PERMIT NO. Q!- as w Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIk� SOI L TEST RATIOt INSTALLEA�� l/d' REMARKS d 111.. APP ED DATE l LEGAL / �� 72-013 (Rev. 3/78) U MU104 X <71 X ]FIP'0:yId "T", aTe' P4 C; hl C1 FR eN <3 E:::', . . .... ..... TH AND ENVIRONMENTAL 3TECTION 82S STREET, ANCHORAGE, AK. Q 0:1. 264-4720 PERM I T NO. 830791 LLD 19 lq-ql APPLICANT BETHARD SRA BOX 1698K 99507 3, 6 0�; t7i4, A TJ 1::jr%l I LOW T I_ 3A 8 1 OR AK E S I:) LOT SIZE 5040C SOUARE A. -ET Type of sail absorption system is: TRENCH laximum number of bedrooms = .:.`3 Soil rating ISO FT/8R}= SS The required size of the sail absorption system is," The length dimension IS the length (in feet) of the trench or drainfield., The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation tin feet). There is no set Width for trenches. The gravel depth IS the mtnimum depth of gravel between the outfali pipe and the bottom of the excavation tin feem, FR Ey <1 Ll A. r- EY 41 ER 9E.F? T:*.?- -,4::: :ik 1", .-K 0 k: Ji :q'.` E-'5. Permit applicant has the responsibility to inform this department curing the in5lollation inspections of any wells e0jecent to this property and the number of residences that the well will serve., --- --- --- V SNR j C-3 C W > ONFREE FZFF?ALJ J" VFFCA BacHfilling of any System Without finsl inspection and approval by this department Will be Subject to prosecution,. linimum distpnce between a well and any on-site sewage dispossA system 100 feet for a private well or ISO to 200 feet from a pubJic well aependinQ upon the type of public we .S..{.., minimum distance from a private well to a private sewer line is 2S feel and to a community sewer line is 7S feen Other requirements may appJy. Specifications and construction diagrams are avaAable to insure proper installation., F" *,;a j>j W.... e::,.. E3 ey C: C?nl W Ey r ­ I certify that 1: 1 am familiar With the requirements for on-site sewers iii no wells as set forth by the municipolity of Anchorage. 2: 1 will instaU the system in aCCordanCe With the codes. 3: 1 understand that the on-site sewer system may require enlapgement if the residence is remodeled to include more than 3 bedroomii: AGNED: APPLSCANT BETHARD CONTRUCTION ISSUEO BY DATE I a.� ....... 9-1 ......... ....... ..... .... "INICIPALITY OF ANCHORAGE Department Health and Environmenta: :otection 825 L Street, Anchorage, AK. 9j501 264-4720 # # # HANDWRITTEN PERMIT # # # WS6L .DIOR ON-SITE SEWER PERMIT Applicant: . ', 1G�_-"� ;: �.. Mailing Address: ;5,(2_,A) Location: Phone Number: Legal Description: 2�d"C�_ t r` Lot Size: Type of Soil Absorption System Is: Trench: ✓ Drainfield: _ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: _1_5_ Soil Rating(sq.ft/br) Rs The Required Size of the Soil Absorption System Is: DEPTH _ _ LENGTH ..35Z . GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. # # # TWO(2) INSPECTIONS ARE REQUIRED # # # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. PERMIT EXPIRES DECEMBER 31, 1 9 3 1 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the reside e i e odeled to include more that 3 b rooms. , Signed • Issued by: pplicant Date: SWP / 0 2 4 (1/81) 77 0' SOILS LOG NICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 13 PERCOLATION TEST Pouch 6650, Anchorage, Alaska 36502 276.2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR: �—tro. Q V-1�<=L" m DATE PERFORMED: Z LEGAL DESCRIPTION: lid l 3A 1 V I [o Ara k e SU b� DEPTH ` SLOPE SITE PLAN {FEET) OYG'" b.rdCt'� 1 2 ^• 3 .........`" 4 t 5 6 7 ............................. . -8. 9- 10- 12 1012 _ 13- 14- is- 16- 17- 18- 19 - 20 314151617 181920 COMM Cour-5f- 5" + Ira ✓d WAS GROUND WATER Y S ENCOUNTERED? /// OL ��� P r � 4V4If* IF YES. AT WHAT/ � E DEPTH? P® °'li•t �x �� Az I� „A �' PO ®W BPPOO. g LN 9'• ° D P.Do ® PnP o "iHOh1A3 iq ° �.\ 2248 -Er,, O 16, 0 Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN 13ETWEEPJ FT A FT Municipality of Anchorage C Development Services Department Building Safety Division / On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 Iz r 1�' , s• rr. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL /� FOR A SINGLE FAMILY DWELLING e -=5sve� Parcel I.D. o 1:7— �/ 6 1-.22 1. GENERAL INFORMATION Complete legal description Lot 3A; Block 1; Drake subdivision Location (site address) 2800 E. Huffman Anchorage, AK COSA # [7 g O I g v Expiration Date: % - f �- O 9 Current Property owner(s) Beverly Webb Day phone 345.3611 Mailing address Lending agency Mailing address Day phone Real Estate Agent Trina Kindred Day phone 665-6544 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Weil ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site❑ Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S s s Engineering Address 15861 S. Birchwood Loop Rd. Chuglak, AK 99567 Engineer's Printed Name Robert A. Shafer S. DSD SIGNATURE Approved for _� bedrooms. Disapproved. Phone 6942978 Date !f / G Conditional approval for bedrooms, with the following stipulations: ^LLdW In 76 n[5: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: /Pace Original Certificate Date: (R. ties) Municipality of Anchorage •.: Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 080190 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 3A of Drake subdivision. This inspection revealed a nitrate concentration of 5.18 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. SCS WEN 1091269001 Client Name S & S Engineering Printed DateR ime 04/132009 13:47 Project Name/M Lot 3A; Block I; Drake S/D Collected DateR7me 04/01/2009 12:30 Client Sample ID Lot 3A; Block 1; Drake S/D Received Date/Time 04/01/2009 12:55 hlatris Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results POL Units Method Container ID Limits Dam Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 04/08/09 04/09/09 NRD Waters Departatent Total Nitrate/Nitritc-N 5.18 Microbiology Laboratory Colony Count _0 Total Coliform 0 Fecal Coliform 0 0.100 mg/l, Sht20450ONO3-F D (<IO) col/100m], SM20922213 col/IOOmL SWO9222B col/IOOmL SM209222D A (<200) A (<I) A (<I) 04103/09 JDZ 04/01/09 DLC 04/01/09 DLC 04101/09 DLC Municipality of Anchorage Development Services Department Building Safety Division ' 1 On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING n Parcell.D. 01q-4c",l' COSA# NO Expiration Date: -.2 .s -Q8 1. GENERAL INFORMATION ' Complete legal description Lot 3A; Block 1; Drake Subdivision Location (site address) 2800 E. Huffman, Anchorage, Ak Current Property owner(s) Beverfy Webb Day phone 345.3611 Mailing address 1120 E. Huffman Ste. 24 Box 584, Anchorage, Ak. 99515 Lending agency Day phone Mailing address Real Estate Agent Debbie Moore wh(eller Williams Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. I -C / IF 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site ❑� Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are *valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system Is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S s s Engineering Address 15861 S. Birchwood Loop chug/ k. N 567 Engineer's Printed Name I/ Phone 694-2979 MMMAM r 5. DSD SIGNATURE /�� ^^ ti Sbcd" Approved for Iy 4.• 1�o., pp bedrooms. Disapproved. tFt�� Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist _X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: 4/AA 2E&OTOriginal Certificate Date: r7 — (Rw loos) \ Municipality of Anchorage Development Services Department :F \ \ j Building Safety Division S • On -Site Water i Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: f �'T ✓ 29, 13fak IL S Parcel ID: 19 (*I �1 A. WELL Well type �IV14 Date complelet jt,�/� 5 Total depf-so-ft. If A, B, or C provide PWSID # Sanitary(o� sea ) y Cased Eo r16 Lit. FROM WE/L LOG Date of test ' 3 Static water level 00 ft• Well production * � 5�t7 9 P.M. WATER SAMPLE RESULTS: Coliform —0—Colonies/100 mL Nitrate �SlrngIL Arsenic: b7 ug/L date of sample: (0ce) B. SEPTICIHOLDING TANK DATA Well Log (YfF>*l� Mo`' Wires properly protecte�`) C-5 rt Casing height (above ground) in. AT INSPEC ION Ito 0 02 7 t ft. 6 7 g.p.m. Other bacteria —!L colonies1100 mL Collected by: 34-S EA')&1/VE'821XXV Tank Type/Material LPnG% Date installed Tank size /0 gal.-- FNumber of Compartments _ CieanoutsO) 00 W Rft` Foundation cleanout (Y Depression over nk f1_1%HXi%h water alarm (ltr Dale of pumping `oZ i Pumper `4"�' C. ABSORPTION FIELD DATA _ Date installed 8 aU B Soil rating (g.p.d./ft2 ft=/bdrm 6S System type L�f Ef 1 r Length ,.'. �jGJ ft. Width 3.0 fL Gravel below pipe •d ft. 1 Total depth ft. Eff. absorption areal f? Monitoring For 3 bedrooms g tube � : Depression over field D Date of adequacy test % 0 Result (Pas 1-0115) ail) r� ,r Fluid depth in absorption field before test Q in. r Water added�al. New depth tn. r 4150+ d. Elapsed Time: W min. Final fluid depth in. '' 9f Absorption rate >= 9 P• Any rejuvenation treatment (past 12 mo.) (Y& type) Nc) I If yes, 9' !Wdate D. LIFT STATION 1014 Date installed l 'Pump on' level at _ in. Datum E. SEPARATION DISTANCES Size in gallons 'Pump off Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic tank/lift station on tot /60 r if - Absorption field on lot /004- Public sewer main A-)& r Sewer/septic service line 02$ h r� Animal containment areas $� High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots On adjacent lots /CJD r �-' Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas /� f SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S /� Property line Absorption field S L Water main A- /m Water service line /D /a Surface water /Gb 1'f' Wells on adjacent lots /DO SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: I Property line /O >` Building foundation /O /L- Water main N Water Service line /O Surface water /CX% 'f Driveway, parking/vehicle storage /O +` Curtain drain _A)MC Kt NWells on adjacent lots -/OO // F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined b review of Municipal records that conformance with MOA COSA wic Engineer's Printed Date COSA Fee $ 1q50 — Date of Payment 23 Og Receipt Number (Rev. 11105) h field inspections and above system$ are in Waiver Fee $ Date of Payment Receipt Number SOS ReLN 1082450001 Client Name S R S Engineering Project lame/a UA BI Drake SD Client Sample ID UA Ill Drake SD Matrix Drinking Water P\\'SID 0 Sample Remarks: All Datesfrimes are Alaska Standard Time Printed Daterime 06/1912008 14:41 Collected Datefrime 06/04/2008 16:30 Rewired Datdl'ime 00/04/2008 16:45 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic Waters Department Total Nitrate/Nitritc-N ND 5.00 ug/L EP200.8 C (<10) 06/12/08 06/19/08 NRB 4.37 0.100 mg/L SN1204500NO3-F B (<10) 06/17/08 JDZ Microbiology Laboratory Colony Count 0 col/IOOmL SM20 92220 A (<200) 06/04108 DLC Total Coliform 0 col/IOOmL SM209222O A (<I) 06/04/08 DLC Fecal Coliform 0 col/IOOmL SM2092220 A (<I) 06/04108 DLC (,deM HUFFMA ROAD *_ ­j EAST - 180.001 `10' UTIL. ESMT.--�, p trorsmission lines or other v;sible easements on said property except as no cc ed .ereoa- O ' ,t9=L, Anchorage, :.Icska. WELL o CD Guilder, prior to conslruaion, to verity pro: csed N 1 tui!;!' -7 grade rotative to finift+d grade and utility ccnnectio r.f and O •� �� ti'+ •.,.•• �j o �✓.-w t ea,srerce of cry sosemerts, covenants or restrictiors rh,ch do not c;peor on the re- i���::�—. ?e o O • y " 3 ~O 0 ry p ti} t2:1I �O �� m N 0 Z �� c Z r.V OO / rcS.tao DECK Z ,dSEPnC vENT� 0 10 UTlL ESMT. W EST - 180.001 I SCALE: 1�= 50' (PLOT PLAN: IAS -BUILT: X (GRID: 2834 (DRAWN BY: PLC 'CHECKED BYL.AA)Z I WAYt SUITE- A-3 a s [EOOHEERS ANCH5630 ORAGE, UV9502 (907) 277-1491 I hereby certify that 1 hove surveyed the following described property, Lot o ". ,Blk_, DRAKE SUBDIVISION Anchorage Recording -Precinct, Alaska, and that the improvements siluated thereon ore within the property tines cnd do not overlap or crroa:hcn the property lying adjacent thereto, that no improvements on property lying c!jo=ent thereto encroach on the premises in question and that there are no roadways, I h trorsmission lines or other v;sible easements on said property except as no cc ed .ereoa- Doted this day o} a•TC3CR ,t9=L, Anchorage, :.Icska. ,�� .f ;q-%THCM4SR.SJRMr i '. II is tee responsibility of the c..ner a Guilder, prior to conslruaion, to verity pro: csed cX y ., 3167-$ = is •, S': 1 tui!;!' -7 grade rotative to finift+d grade and utility ccnnectio r.f and to determine fns •� �� ti'+ •.,.•• �j o �✓.-w t ea,srerce of cry sosemerts, covenants or restrictiors rh,ch do not c;peor on the re- i���::�—. MUNICIPALITY OF ANCHORAGE • DEPARTMENT OFHEALTH &HUMAN SERVICES',, Division of Environmental Services,-,, On -Site Services Section '= P.O: Box 196650 Anchorage; Alaska 1'99519-6650 CERTIFICATE OF HEALTH AUTHORITY,. APPROVAL FOR A SINGLE FAMILY DWELLING AD", � r Parcel I.D. # O i 1L! G l: a `� _,,r : `':' HAA # A. GENERAL INFORMATIONun -c19�"± :#JAI face, iCtY7""?•' 14�yRF��: [rr�S i:. -.-'Complete legal description.Lot 3A; 82ocLir aDTAke,1Su6iCcv��6ion V, Location (site address or directions) 2800 E. Huj6man Anchorage; AK 7 J Property owner 'every GJebti Day phone�344-7576' Mailmg.address 8000 'Peenhbcucg S�cee Anchorage, AK 99507 Lending agency " s Day phone `fif 3 MailRhin address f L r� w� Agent" �DaK phone�� 'f Ha .fa 3 ��'iia't"1't5WA4P,. *e r K °�3° Unless otherwise requested HAA wlll be held for pickup 4r"nr ► i rMBE'"�.'� 3ter I �r �NI;IR`OFBEDROOMSag��fi 4�3 ?S~'� TYPE OF WATER SUPPLY �:{:;' t k} t+ Raw A "'j.'t� ��� � �1 R / +� ndividual well��x L ; , is kNi , 1�. •' Community well Z 40 n1 C vr�•t �pP Y )��str5 1 'yfi�31�k�`�'76ukjd$¢� iUM Ys i Public'"water , tri rue m _� .ir" NOTE. -1f community well system, provide written confirmation from StateADEC ing to the legality and status of system t, T 4= 4 TYPE OF WASTEWATER DISPOSAL, t�.::. ;!r," a^ ... ._ - ,e,•tl�t �.nrwr.. .:w�.... ,...,..t.... ' C tr'� .� �Y � , Individual on-site XXX s° tih^.k5'R ;'4 .� Holding tank.= t4+3 s,.F ,� ..,<�.:f.,..3,:: s,.�W'i'l.'E`'T�w,t.. ''u#tett Pt,.til�i:f::� <tc': i'Y; �� .. t ?vt•`.±', f....Community on site,,, —.�( 1 �{ >.) 'y i, a+ ; rix. o e N 611 I Public sewer r tsy,n r 4 +Aw Ty H fft>f I°P['�, 7Y ,,- NOTE: If community wastewater system, provide written confirmation from Stafe .. f, -o attesting to the "legality and status of system } r ., -t ` 72.025 (Rev. 1/81) Front MOA 621 9 9 1 ti TI _ AI pr i tk an col res M -o= ..� ROEERT t COV -'CE 8801 .,. ...: ... LJ J.(' 0 e �9t3a^t4 ew HS.y4, bedrooms. MW , r bedrooms, with the following stipulations e a - Date071 lYyy '3itY r" CAUTION • rtment of Health and Human Services (DHHS) issues Health Authority in the representations given in paragraph 5. above by an independent State of Alaska. The DH HS does this as a courtesy to purchasers of homes i satisfy certain federal and state requirements. Employees of DHHS do not i before a certificate is issued. The Municipalityr of Anchorage is not the professional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LT.'__,v4 .RI -L)> Parcel I.D. d 17 -416 / A. Well Data Well type �It 0A -7F— If A, B, or C, attach ADEC letter. ADEC water system number Log present (YARP Total depth NO wt. GO(Arih Date completed g0fY__ Driller Cased to -76 Casing height /V Sanitary seal &N) �S Wires properly protected (&N) Y ,i n c•r,� V.1 14 A A FROM WELL LOG AT INSPECTION rn Date of test /11 1g3 ` /a� hr'. Static water level�(7 j z n C Well flow C,7 Y g.p.m. g.p.m._ m c Pump levelly K l+ m n -*E P 6 tiC i' n 'Ir V( o 11 S rl A q o c SEPARATION DISTANCES FROM WELL TO: Septic/he" tank on lot ��� � O" t � On adjacent lots Absorption field on lot OC/S -I ; On adjacent lots Public sewer main Public sewer manhole/cleanout QAA r Sewer service line 0 Petroleum tank �On�z /� �ww�✓ WATER SAMPLE RESULTS: ` Coliform Nitrate �IbIm�/� Other bacteria oc Date of sample: 5 Collected by: s & s ENGINEERING 17,0134 Eagle River Loup K034 No. 204- 0 4B. B.SEPTIC/LANK DATA Eagle Diver, Alaska 99577 Date installed oZL�`o I Tank size 10C)0 (SA -C Compartments Cleanouts 6)N) y f_- Foundation cleanout (Y/ d� Depression (Y/O /1-6 High water alarm (Y/ Alarm tested (Y/N) Date of pumping �,' �61� /f Pumper/L- SEPARATION DISTANCES FROM SEPTIC/HG TANK TO: Well(s) on lot �+ On adjacent lots 1 Ud Foundation t + To property line 10 a` Absorption field Surface water/drainage 100 k 2 Water main/service line /v 4 72-026(3/93)•Front CONTINUED ON BACK PAGE STATION Date installed ---/--f ' Manufacturer Size in gallons Manhole/ eels (Y/N) Vent (Y/N) "Pump on" at "Pump off" Level at _ High water alarm level Cycles tested Meets MOA electrical codes (Y/ SEPARATION NCE FROM LIFT STATION TO: on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed g-�� `8 Soil rating (QPB�Rl) 8S sF/& System type Tl'cQ% 7 Length �S r Width �� Gravel thickness -/ Total depth R Total absorption area 'E7302, SE Cleanout present &I) q Depression over field (Y/N) 11-16 Date of adequacy test 6 Lc?Q- J .5 Results (pass/fail) PF}SS for -3 Bedrooms Water level in absorption field before test oZ t , After test Peroxide treatment (past 12 months) (Ylfb`7 Krx)wr-j If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 0 y f- On adjacent lots t Od 4- Property line //U V To building foundation f,0 k To existing or abandoned system on lot On adjacent lots o2 (�` Cutbank IJ %/a- Water main/service line -� Surface water �w L Driveway, parking/vehicle storage area �\ �0 Curtain drain U vii— t--Nowl- E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. OF Signature y� �+.• f:fi^' i3:yg' .1i#:?:">sa3cti+gy Engineer's Name f [ 0 (3 i rZ T" C- C 0w A r� �„, • .' ,.�1 rr 33.. ROBERT C. COWAN r w Date b 1 3 C9 l�` CE - 8801 31 u�a� •��r� ti- UtL­b HAA Fee $ ✓0 Date of Payment "--*) 5 Receipt Number r/ 0 >3 (;�4 72-026 (3/93)" Back Waiver Fee $ Date of Payment Receipt Number ALMe Environmental Services Inc. CT&E Ref # 95.2495-3 Matrix BOATER Client Sample ID L3A BLKI DRAKE $/D Client Nam* S & S =111URINO WORK order 19622 Ordered By R. COWAN printed Date 06/22/95 W 16:16 hre. Project Name Collected Date 06/19/95 a 14:SS hre, Project# Received Date 06/20/95 0 10:30 hrs. PWSID UA Technical Director STEPHEN C. RDE Released Sample Remarks: SAMPLE COLLECTED BY: LT -W. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Ihit Nitrate -N 1.63 mg/L EPA 353,2 110. 06/21/95 OAA www* wrwweawSsrw wNw..w-.rw.........ww............. Ppeeian..ucwwon- Above VA - Unavailable See Sample Remarks Above NA - Not Analyzed ,;U ■ Undetected, Reported value is the practical quantification limit. LT - Less Than Z - Secondary dilution. GT & Greater Than Zoe] eTL'ON TTETV69LO6 4- 9NI1S31-1dI083WW00 M;9j 96/EE/90 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date March 28, 1986 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3A Blk 1 Drake Subdivision Location (address or directions) 2800 E. Huffman Rd. (b) Applicant Name Beverly Webb Telephone: Home 345-3611 Business 344-7576 Applicant Address 2800 E. Huffman Rd., Anchorage, AK. 99176 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ® ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Alaska Mutual Bank Telephone 349-5800 Address750 W. Dimond Blvd 4201, PO Box 99003 Anch Ak 99509-9003 (e) Real Estate Company and Agent N.A. Address Telephone (f) Mail the HAA to the following address: 2800 E. Huffman Rd., Anchorage, AK. 99176 S ( >_1 'I J �7 (42 2. TYPE OF RESIDENCE Single -Family E2 Multi -Family ❑ Other Number of Bedrooms Three (3) 3. WATER SUPPLY Individual Well E� Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Ej Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11184) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION L� As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Boysen & Associates - Engineers Telephone 262-9537 or 262-9527 Address 391 Diane Lane, Soldotna, AK. 99669 Date March 28 1986 AyR t 441—Engineer's Seal 7. DHEP APPROVAL C�) Approved for 1- bedrooms by AVYII ate Approved Disapprove Conditional Terms of Conditional proval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY Of ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA)��R 8 CHECKLIST FEBRUARY 1884 264-4720 QD (� 9 P Legal Description: Lot 3A, Blk.' 1 i\ �+ Drake Subdivision A. WELL DATA Well Classification n If A, B, C, D.E.C. Approved (Y/N) Yes Well Log Present (Y/N) Yes Date Completed 9-14-83 Yield 900 gph Total Depth 80 ft- Cased to 76 ft. Depth of Grouting None.` Static Water Level - 40 ft. Pump Set At Info. not available Casing Height Above Ground 24" Sanitary Seal on Casing (Y/N) Yes Electrical Wiring in Conduit (Y/N) YeS Depression Around Wellhead (Y/N) No Separation Distances from Well: To Septic/Holding Tank on Lot 102.6 Ft. ; On Adjoining Lots Over 100 ft. To Nearest Edge of Absorption Field on Lot 115 ftp ; On Adjoining Lots Over 2nft To 'Nearest Public Sewer Line Over 100 `ft. To Nearest Public Sewer Cleanout/Manhole N•A. To Nearest Sewer Service Line on Lot N.A. Water Sample Collected by Richard L. Boysen P.E. ; Date 3-27-86 Water Sample Test Results Satisfactory Comments A single tap produces over 2.0 qpm, which is more than adequate for a single family three bedroom home- B. SEPTIC/HOLDING TANK DATA Date Installed 8-24-81 Size 1000 gal. No. of Compartments two (2) Standpipes (Y/N) Yes Air-tight Caps (YIN) Yes Foundation Cleanout (Y/N) No Depression over Tank (Y/N) No Date Last Pumped 3-22-85 (see receipt Pumping/Maintenance Contract on File (Y/N)` No ; for Holding Tank High-Water Alarm (Y/N) NA Temporary Holding Tank Permit (Y/N) NA Separation Distances from Septic/Hoi4ing.3'zrak: To Water-Supply Well 102.6 Ft. To Building Foundation ` 20 ft. To Property Line 58 ft. To Disposal Field 8 ft. To Water Main/Service Line N.A. To Stream, Pond, Lake, or Major Drainage Course N.A. - - - Comments The septic system was loaded to over 10 times its soil rating and was found adequate. Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 85 sfpbr Type of System Design Trench Date Installed 8-24-81 Length of Field 35 ft. Width of Field 36 inches Depth of Field 8 ft. Gravel Bed Thickness 4 ft. Square Feet of Absorption Area 280 s. f . Standpipes Present (Y/N) Yes Depression over Field (Y/N) No Date of Last Adequacy Test 3-27-86 Results of Last Adequacy Test Satisfactory; field was adequate with loading 10 times the soil rating. Separation Distance from Absorption Field: To Water -Supply Well 115 ft. + To Property Line 23 ft. To Building Foundation _ 30 ft. To Existing or Abandoned System on Lot NA ; On Adjoining Lots N.A. To Water Main/Service Line N.A. To Cutbank (if present) N.A. To Stream/Pond/Lake/or Major Drainage Course N.A. To Driveway, Parking Area, or Vehicle Storage Area 30 Ft Comments This system is more than adequate for single family three bedroom home. D. LIFT STATION Date Installed Size in Gallons Not Applicable "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments — Dimensions Manhole/Access (Y/N) _ "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify t I have checl d, rified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date 3-28-R6 Company Boysen & Ass ciates MOA No. Receipt No. :7935 3 Date of Payment s, Amount: $ L : rim Page 2 of 2 72-026 (11/84) _,k &deem&** e6a 06,�Q4) kow m20Bt A040 N0. 2l 133-E .. NR' 3 Engineer's Seal Boysen & Associates - Engineers 391 Diane Lane Soldotna, AK. 99669 March 28, 1986 Ronald & Beverly Webb 2800 E. Huffman Rd. Anchorage, AK. 99176 Re: Recertification of Septic and Well Systems Lot 3A, Blk 1, Drake Subd. Dear Mr. & Mrs. Webb: Pursuant to your request I have searched the Municipal records for available data for the referenced lot, obtained a water sample, conducted a water flow test and a onsite waste water adequacy test for the referenced lot. My findings indicate that the water is satisfactory as to quality and more than ample in flow and that the septic system is more than adequate for a single family three bedroom home. Transmitted herewith for your records and to aid in your re- financing please find the following data. 1. Copies of all the public documents on file at the Municipality of Anchorage 2. A copy of the latest (3-22-86) septic tank pumping receipt. 3. Northern Testing Laboratories, Inc. water quality report dated 3-28-86. 4. An as -built recertified 3-27-86, originally prepartd by S&S Engineers. 5. An application (blue) for "Certificate Of Inspection For Health Authority Approval Of On -Site Sewer and Water Facility". 6. A form (gray) "Municipality Of Anchorage (MUA), Health Authority Approval (HAA), Checklist - February 1984". 7. Four polaroid pictures of the referenced lot water and sewer systems. Thank you for the opportunity to be of service to you; if you have any questions please do not hesitate to call. Very truly yours, Bo en & Associates - Engineers Richard L. Boysen, P.E. EAST -180.00' '--10' UTIL. ESMT�� O O , 6 WELL ----- o N O PORCH 00 o o 4:) 4 } o ss. 43.11 0 00 X04 N r` o Z ' 'r i2l 65.06 PECK O 0 EPTIC VENT A 10 UTIL ESMT.- WEST - 180.001 Mi No Change as of 3-27-86 e� � �°a�OOPz ftl�„tr Y9 • O0a�09Ui.G•'±. ,�tlFf r:G�� �Oe.O�06"Ja02�o.aex+ceeer, nn ar-r. ,.,."'� ' SCALE: 1 = 50' I PLOT PLAN: IAS -BUILT: X I GRID: 2834 I DRAWN BY: PLC I CHECKED BYaAkr., T) ANCHORAGE, OALASKA9502 (907) 277-1491 1 hereby certify that 1 have surveyed the following described property, Lot 0 A. ,BIk I , .A-+% t a DRAKE SUBDIVISION Anchorage Recording Precinct, Alaska, and i ��' �F��.. that the improvements situated thereon are within the property lines and do not overlap or / � ; `• encroach on the property lying adjacent thereto, that no improvements on property lying OTH adjacent thereto encroach on the premises in question and that there are no roadways, Of* .. ....... . . ....� transmission lines or other visible easements on said property except as indicated hereon. � y r e� / e Q r r THOMAS R. S •fTH j° Doled this 9 da of tXTOBER 19 Anchors a Alaska. A It Is the responsibility of the owner or builder, prior to construction, to verify proposed �%. 316T --S ,r l building grade relative to finished grade and utility connections and to determine the ,�r °•ee.°°.r9•'Alp existence of any easements, covenants or restrictions which do not appear on the re- i�At,� corded subdivision plot. %1k1k'W46 � S & S Engineers 5610 SILVERADO - SUITE A-7 - ANCHORAGE, ALASKA 99502 • (907) 274.9397 December 23, 1981 Municipality of Anchorage Department of Health and Environmental Protection 825 L. Street Anchorage, Alaska 99501 Gentlemen: This letter will serve as certification that we have conducted a final inspection on the septic and well system for Lot 3A - Block 1 Drake Subdivision. Drinking water test results are attached. 'Phe following items were noted at this inspection: 1. All stand pipes (3 ea.) are above grade and capped. 2. Well seal is in place. 3. No settlement was observed at the well nor over the septic trench. 4. Well wiring was buried. 5. Distance from the well to the tank is 102.6 feet. The system appears to meet all a of Anchorage codes. THS/plc � $�f�n J 'Y J• f'Y l000ua • o oao.••oxx °~v ��� n� -a m THOMAS R. 5M!'tl-( s ® 7 OA f °°a .C.Gv-F- e°° A ll Si ye able Municipality .R. Smith, P.E.